House-Passed Bill Would Create More Primary Care Residency Programs

The House has taken steps to alleviate the growing shortage of primary care physicians by passing a measure that would establish an interest-free loan program for hospitals to start new osteopathic or allopathic residency training programs.

The Physician Workforce Enhancement Act of 2008, H.R. 2583, now under consideration by the Senate Health, Education, Labor and Pensions Committee, would make interest-free loans available to hospitals to start new osteopathic or allopathic residencies in one of five medical specialties or some combination of the specialties. The five specialties are family medicine, internal medicine, pediatrics, obstetrics and gynecology, and behavioral or mental health.

The bill's loan program would focus on hospitals located in geographic areas that currently lack teaching programs. If enacted, the measure could help establish up to 50 new residency programs during the next 10 years, according to a statement released by the American Osteopathic Association, or AOA.

"It is important to understand that for this bill to be truly effective, both U.S. allopathic and osteopathic medical schools must have higher percentages of their graduates going into primary care fields," said AAFP President Ted Epperly, M.D., of Boise, Idaho. "If there are not payment reforms that help draw these students into residency training programs, then these programs will not have a pipeline of medical students to fill their residency positions."

"We could have a situation where you may build it, but they will not come," he added.

The Physician Workforce Enhancement Act is budget-neutral -- hospitals would be required to pay back the interest-free loans within 10 years. Hospitals could use the loans to offset the cost of residents' salaries and benefits, faculty salaries and other costs directly attributable to the residency programs.

"It's not a grant," said Shawn Martin, director of government relations for the AOA, describing the loan provisions of the bill. "It is simply an interest-free loan and does not have an impact on other spending."

The Senate is unlikely to pass the legislation before the end of the current 110th Congress. As a result, the House and Senate will both have to pass the bill in the next Congress before it becomes law. The House passed the measure by a unanimous voice vote on Sept. 23, clearly demonstrating the deep bipartisan support the bill has engendered. That support should carry over into the next Congress, giving the measure added traction, according to bill proponents.